Are recheck ultrasounds considered "diagnostic"?

[Feathered_Feet]

In the throws of insurance reimbursement (yay!). Horse has a suspensory injury, and we’ve been doing regular ultrasonographic rechecks over the last few months. I have a “diagnostic copay” for these follow-up/recheck ultrasounds, but from my perspective, we’re not diagnosing at this point. We know what the diagnosis is, now we’re monitoring the condition. Am I wrong, or is my insurance trying to make a sucker out of me?

All perspectives appreciated. Especially from vets and/or folks with insurance experience.

[Arlomine]

I have a feeling that “procedures “ fall under one of two Categories. Diagnostic, or therapeutic. So… This imaging is in a sense diagnostic because if things start to go off line you are diagnosing the need to change the treatment plan, or conversely, to stay the course.

[No1]

It is diagnostic. Each ultrasound determines where your horse is in the rehab process and determines which steps you will be taking next.

Also, when speaking with your insurance company, you want to avoid implying that anything is preexisting or saying anything that may encourage them to close the case. Usually, when they close a case like this, they then exempt that leg from the policy for some period of time.

[Feathered_Feet]

Thanks both for the input. I recognize what the rechecks are doing, but I guess I didn’t assume that limit/copay would apply to every tool used in a non-therapeutic way - I assumed when I read the contract that “diagnostic” meant when you are diagnosis the condition (which is the most common use of the term). For instance, we don’t say we are re-diagnosing the injury, we say we are monitoring the healing process. Just like when we pull blood from people with diabetes, we aren’t diagnosing the diabetes each time, we are monitoring their condition.

Uggg, insurance!! Although they are reimbursing a fair chunk. I guess I should be grateful.

Thanks again.